Is it possible to cure celiac disease in a child? Celiac disease - what is it, what are the symptoms and signs in children, how is it diagnosed and what is the treatment? Prognosis of the course of an atypical form of celiac disease in children

Although modern medicine has no methods that can completely cure a person from celiac disease, strictly avoiding foods containing gluten usually stops further damage to the lining of the small intestine and eliminates associated symptoms such as diarrhea.

Causes of celiac disease in children

Celiac disease in a child can occur as a result of heredity and related factors that can trigger this disease. A child who develops celiac disease will likely inherit the risk from one or both parents. The disease usually does not begin to develop immediately, but only as a result of consuming gluten-containing products.

Celiac disease is different from wheat allergy. Allergies occur when different parts immune system are activated by wheat, causing allergic symptoms such as urticaria and bronchitis.

Symptoms of celiac disease in a child

How does celiac disease manifest in children? Symptoms of celiac disease in children can range in severity from mild to severe.

Symptoms of celiac disease in infants under one year of age

Children between birth and one year of age may experience the following symptoms:

• change in consistency and appearance stool (mushy, foamy stool)
• bloating (colic)
• frequent regurgitation (especially in newborns)
• light weight
• slow growth
• rickets (curvature of bones)
• late teething
• early caries

Symptoms of celiac disease in preschool children

Children preschool age may experience the following symptoms:

• diarrhea (diarrhea)
• vomit
• bloating
• abdominal pain
• poor appetite
• delay in height and weight or difficulty gaining weight
• irritability and moodiness

These symptoms can begin at any age after a child begins eating gluten-containing foods, from infancy to adulthood. In some cases, the child may not experience any of the most common symptoms, but may have problems with slow growth, Iron-deficiency anemia, skin rash or dental problems.

Symptoms of celiac disease in older children

In older children, symptoms of celiac disease may include:

• constipation or diarrhea
• oily feces(which float on the surface)
• bloating and gas
• The height and weight of a child with celiac disease is noticeably behind compared to peers
• have difficulty gaining weight
• anemia
• bone thinning

Skin symptoms in children with celiac disease

People with celiac disease may experience a skin condition called dermatitis herpetiformis. This disease most often occurs in adults with celiac disease. Children with celiac disease rarely suffer from this disease, especially before puberty. A child with dermatitis herpetiformis may not have gastrointestinal symptoms.

Symptoms of dermatitis herpetiformis include:

• severe itching
• raised, fluid-filled blisters on the skin, usually occurring on the elbows, knees, buttocks, lower back, face, neck, torso, and sometimes in the mouth
• burning

Scratching the itchy areas of the skin causes the blisters to rupture and then dry out, resulting in areas of darkened skin and scarring. A skin biopsy may be required to diagnose dermatitis herpetiformis. The child's condition improves after eliminating gluten from the diet. Significant improvement usually occurs within a few weeks to several months, but only if the child strictly adheres to a gluten-free diet.

Dental problems

Children with celiac disease usually experience changes in their permanent teeth, such as:

• changes in tooth enamel color (cream, yellow, brown, or discoloration)
• grooves or pits in the teeth

Thinning bones

Children with celiac disease are at risk of weakening bone tissue, which is caused in part by poor absorption of vitamin D and calcium. Treating celiac disease in children with a gluten-free diet can resolve the problem in most cases. Sometimes taking vitamins and calcium supplements is also recommended.

Other symptoms

Celiac disease may cause vague or minor symptoms, such as:

• fatigue
• mild iron deficiency anemia
• slight growth retardation

Once a child is confirmed to have celiac disease through a small intestinal skin biopsy, the only treatment option is a gluten-free celiac disease diet.

Which children need a diagnosis of celiac disease?

Not all children need to be diagnosed with celiac disease. If you are concerned that your child has symptoms that could be caused by this disease, ask your pediatrician whether your child should be tested. It is very important to feed your child his normal diet before testing, as putting him on a gluten-free diet may change the test results, making it difficult to make a diagnosis.

If your child has symptoms

Children experiencing the following symptoms should be tested for celiac disease:

• Being short or underweight for age, especially if the child's growth has slowed significantly over time or if the child is significantly smaller than others his age.
• Diarrhea lasting more than a few weeks.
• Chronic constipation, recurrent abdominal pain or vomiting.
• Some types of dental problems.
• Delayed sexual development.
• Iron deficiency anemia that does not respond to treatment.

High risk groups

Children at risk include:

• whose first-degree relatives (parents, brothers, sisters) have celiac disease
• with Down syndrome
• with type 1 diabetes
• with selective immunoglobulin A (IgA) deficiency
• with Shereshevsky (Turner) syndrome
• with Williams syndrome

Diagnosis of celiac disease in children

Several diagnostic procedures may be necessary to diagnose celiac disease. Your child must continue to eat gluten-containing foods until testing begins. Putting a child on a gluten-free diet before diagnosis may skew test results, leading to an inaccurate diagnosis.

Blood analysis

The first step in diagnosing celiac disease in a child is a blood test. A pediatrician, family doctor or nurse can do this test. A blood test indicates whether the child has elevated levels of antibodies (proteins) to tissue transglutaminase, which is part of the small intestine. Levels of these antibodies are usually high in people with celiac disease (as long as gluten is present in their diet) but almost never increase in people who do not have celiac disease. If the tissue transglutaminase antibody test is positive, a small bowel biopsy is recommended to confirm the diagnosis of celiac disease.

Small intestine biopsy

If a blood test shows high level tissue transglutaminase antibodies, the diagnosis must be confirmed by examining a sample of the small intestinal mucosa using a microscope.

Taking a sample is called a biopsy, which is usually done during an upper gastrointestinal endoscopy. During this procedure, a small flexible tube called an endoscope, which has a camera on the end, is inserted through the child's mouth and into the small intestine. While the child is sedated, the endoscopy is performed by a pediatric gastroenterologist. The camera allows the doctor to examine top part digestive system and take small tissue samples from the surface of the small intestine for biopsy. The biopsy is a painless procedure - so the child will not feel pain during it.

Typically, inside the small intestine, on its mucosal surface, there are finger-like structures called villi that allow small intestine absorb nutrients. In people with celiac disease who eat gluten, the villi become damaged and flattened, preventing the absorption of essential nutrients. Once a child stops eating gluten, the villi recover and are able to absorb nutrients as normal again.

Treatment of celiac disease in children

The only treatment for celiac disease in children is to completely eliminate all foods and drinks containing gluten from the child's menu. If a child is not getting enough nutrients due to illness, he or she may need to take dietary supplements, high-calorie drinks, or vitamins.

A gluten-free diet for celiac disease in children is recommended if the child:

• abnormally elevated antibodies in the blood
• a small intestinal biopsy confirms celiac disease and the child experiences symptoms of the disease
• a small intestinal biopsy confirms celiac disease and the child is at high risk (even if there are no symptoms)
• skin biopsy confirms dermatitis herpetiformis

If, as a result of antibody testing and biopsy, the diagnostician is not completely sure of the diagnosis, or if the child does not experience symptoms of celiac disease, additional testing may be necessary.

How can we stop eating gluten?

A strict gluten-free diet is the only treatment for celiac disease. Eating even small amounts of gluten can cause intestinal damage, causing a relapse of disease symptoms. A gluten-free diet requires a lot of discipline and care from both parents and children.

Meeting with a nutritionist experienced in treating celiac disease can help parents and children:

• It is better to understand which products are safe for your child and which are dangerous.
• What to look for on food and drug labels to determine whether they contain gluten or not.
• How to plan a well-balanced gluten-free diet.
• Determine if vitamin and mineral supplements are needed.
• Make the necessary adjustments to ensure a safe gluten-free diet in your home and school.
• Find gluten-free substitutes for foods your child loves.

Some people feel relieved when they learn they have celiac disease. Others, upon learning that they need to follow a gluten-free diet for the rest of their lives, feel overwhelmed. Either way, it's important to remember that a gluten-free diet is key to recovery. Luckily, life on a gluten-free diet has become easier due to the increased availability of gluten-free foods.

Some children with celiac disease are deficient in vitamins and other nutrients. Talk to your doctor, nurse, or dietitian about taking a multivitamin and how to incorporate nutrient-dense, gluten-free foods into his diet.

What you can and cannot eat

The most common cereals in developed countries are wheat, rye and barley. These grains contain gluten and are added to many processed foods.

• Avoid foods containing wheat, rye and barley.
• Fresh fruits, vegetables, milk, eggs, fresh unprocessed animal and poultry meats, rice, corn and potatoes are gluten-free, making them safe for children with celiac disease. Gluten-free grains such as buckwheat, quinoa and millet are good sources of nutrients, but can be contaminated by wheat. These grains and flours made from them should only be used if they are labeled “Gluten Free” on their packaging.
• Read labels on processed foods and seasonings, paying particular attention to additives such as stabilizers or emulsifiers, which may contain gluten.
• A child may initially have problems consuming dairy products; many people with celiac disease may have temporary lactose intolerance. If your child's symptoms worsen after eating lactose-containing foods, you may want to temporarily remove them from your child's diet.
• Wheat-free products are not necessarily gluten-free. Read the ingredients on the package or contact the manufacturer if you have questions about a specific product.
• While oats are naturally gluten-free, they can sometimes be contaminated with wheat during processing. Before purchasing oatmeal or products that contain oats, you must make sure that they have not been contaminated with wheat during the production process - the products must be labeled “Gluten Free.” Children newly diagnosed with celiac disease should avoid consuming oatmeal and foods containing oats until their small intestines have fully recovered. After that, you can diversify their menu with oatmeal. Oats are usually added in small portions, which are increased gradually. This is done to avoid any symptoms caused by increasing fiber in the diet. Careful monitoring of symptoms is important as there is a small percentage of the population who are intolerant to the protein found in oats.

Is a strict gluten-free diet really necessary?

A lifelong gluten-free diet is the only treatment for celiac disease.

Children who do not experience ongoing symptoms of celiac disease often find it difficult to follow a strict gluten-free diet. In fact, some doctors question the need for a gluten-free diet in people without symptoms. However, most experts recommend a strict gluten-free diet for all children with celiac disease, whether the child has symptoms or not. They recommend a continuous gluten-free diet for the following reasons:

• Some children with celiac disease develop vitamin and nutrient deficiencies even if they feel well. If left untreated, deficiency can cause problems (such as anemia due to iron deficiency or bone loss due to vitamin D deficiency). People with celiac disease who do not follow a strict gluten-free diet are more likely to have certain health problems, for example, adults may suffer from osteoporosis (thinning of the bones) and their children may have low birth weight.
• Following a strict gluten-free diet usually helps improve energy and a sense of well-being, even if the child does not experience obvious symptoms.

Monitoring during treatment

After starting a gluten-free diet, most children begin to feel better within a few weeks. About six months after starting a gluten-free diet, your child's doctor or nurse may repeat a blood test to check levels of tissue transglutaminase antibodies. Antibody levels should be lower or antibodies should disappear completely as the child continues to avoid gluten-containing foods.

A repeat small bowel biopsy is usually not necessary if the child's condition has improved and antibody levels have decreased since starting a gluten-free diet. A repeat biopsy or other tests may be recommended if symptoms do not improve or if antibody levels remain elevated.

Living with Celiac Disease

A gluten-free diet requires changes for the entire family. Talking with an experienced doctor or nutritionist can help parents and children make the necessary adjustments to a gluten-free lifestyle.

Parents whose children have recently been diagnosed with celiac disease will need to talk to their child's teacher or caregiver about avoiding gluten-containing foods. A common problem in the diet for celiac disease in children is eating outside the home: while traveling, hiking, parties, at school, kindergarten and children's camp. These problems will also have to be taken into account and resolved.

Forecast

Celiac disease is a lifelong disease, as no treatment method has yet been developed to completely get rid of this disease. The main method to control the disease is a lifelong gluten-free diet, which allows not only to control symptoms and heal the mucous surface of the small intestine, but also to avoid all the complications of celiac disease.

Because children with celiac disease may have an increased risk of developing certain infections, vaccination is recommended to reduce the risk of pneumococcal infections (such as pneumonia). The vaccine is administered only once.

Celiac disease in children is a hereditary pathology. Another name is Guy-Herter-Heubner disease. The mechanism of its development is explained by gluten intolerance. The substance is a protein, an excess of which is observed in wheat, barley, rye and food products containing it. Gluten irritates the mucous membranes of the gastrointestinal tract and activates the immune system, prompting it to respond by producing antibodies to its own cells. As a result, autoimmune inflammation develops and intestinal tissue is destroyed.

Factors predisposing to celiac disease

The main cause of Guy-Herter-Heubner disease is genetic predisposition. But various pathologies and conditions can also provoke its development, for example:

• defects of the small intestine;
• weak immunity;
• abdominal surgery;
• infection of the body, affecting the villous structure of the intestine;
• diseases of an autoimmune nature - dermatitis, diabetes, rheumatoid arthritis.

Dr. Komarovsky, together with other specialists, puts forward a viral theory of the origin of the disease. The diagnosis of “viral celiac disease” is confirmed by the detection of specific antibodies to the adenovirus in the blood.

Clinical features of celiac disease

The primary symptoms of celiac disease in children do not appear immediately. In infants, they are observed during the period of introducing complementary foods, when gluten-containing products are introduced into the diet. More clear deviations characteristic of the disease are established before the year, at approximately 7–8 months. For some children, the picture of pathology appears closer to their 3rd birthday.

All parents should know the typical symptoms of celiac disease. These include:

1. vomit;
2. swelling;
3. refusal to eat;
4. bloating;
5. signs of rickets;
6. growth retardation;
7. body weight deficiency;
8. lack of teeth;
9. early caries;
10. mood swings;
11. secretion of fetid, foamy, etc.

Atypical symptoms of celiac disease are a number of disorders that are not directly related to the digestive system. These are:

• arthritis;
• anemia;
• dermatosis;
• hair loss;
• dental problems;
• weakness and increased fatigue;
• symptoms inherent in endocrine diseases.

Untimely treatment of celiac disease causes exhaustion of the body and inhibits the development of the child. As you get older, the clinical picture of the disease changes. In children of kindergarten age, celiac disease is accompanied by abdominal pain, nausea and vomiting, and problems with bowel movements. Physical development The sick child is different from his peers.

In adolescence and young adulthood, celiac disease in children develops against the background of a deficiency of vitamins, minerals and various nutrients that the body does not receive. Help to recognize an anomaly:

1. anemia;
2. osteoporosis;
3. short stature;
4. itching and rash on the body;
5. delayed puberty;
6. underdevelopment of tooth enamel.

How is celiac disease diagnosed?

The pediatrician makes the primary diagnosis based on a general examination of the child and refers the patient to a gastroenterologist. Suspicions are confirmed after receiving answers from the laboratory and instrumental diagnostics. Laboratory research methods include genetic tests, biochemical and general analysis blood, bacteriological, microscopic and biochemical examination of feces.

Among the instrumental ways to diagnose celiac disease are:

• colonoscopy;
• X-ray of the intestine;
• histological analysis of a biopsy taken from the mucous membrane of the tract.

Principles of celiac disease therapy

Treatment for a child with symptoms of celiac disease is varied. The patient is put on a diet, vitamins, enzymes and probiotics are prescribed. Diet therapy involves eliminating foods containing gluten from the diet. In addition to cereals and baked goods, dangerous protein is found in sauces, sausages and dairy products. Children are not allowed to eat ice cream.

Infants are transferred to artificial adapted formulas with hydrolyzed cow's milk protein or soy:

1. Nutri-soy;
2. Frisosoy;
3. Pregestimil.

In case of exacerbation of celiac disease, medicinal mixtures become the basis of children's nutrition. As the condition stabilizes, the diet is gradually enriched with dairy-free, gluten-free cereals, vegetable puree and cottage cheese.

To improve the activity of the digestive glands, enzymes are included in the treatment - Pangrol, Mezim, Creon, Pancreatin. The ratio of harmful and beneficial intestinal flora corrected with probiotics - Bifiform, Acipol, Lactofiltrum.

Vitamin therapy is aimed at replenishing missing vitamins and microelements. Treatment with multivitamins is developed individually. The child must take the course in spring and autumn. Additional indications for taking vitamins are infectious diseases and vitamin deficiency.

Celiac disease is a rather unpleasant but common disease caused by intolerance to plant foods, which found in many products(mainly cereals) and dishes prepared from them.

Symptoms of celiac disease in children are expressed very clearly and cause a lot of inconvenience to the child. In this case, the disease can have a severe course, resulting in significant deterioration general state child's health.

In some particularly dangerous cases, celiac disease can even lead to disability. That is why, having noticed the first signs of the disease, it is necessary to begin treatment as soon as possible, which consists of taking medications prescribed by the doctor, following a diet and the right image life.

Unfortunately, it is impossible to completely get rid of this problem; celiac disease is an incurable disease, however, following the recommendations of the attending physician will significantly improve the child’s quality of life and avoid serious complications.

How does an allergy to formula manifest in an infant? Find out about this from ours.

Characteristics and facts

Celiac disease is congenital or acquired disease, which has a chronic course and cannot be completely cured. In some cases, the child’s body reacts negatively to certain elements contained in food.

If we're talking about About celiac disease, such an irritating ingredient is gluten - a plant protein (gluten) that is part of some food products. Largest quantity gluten free found in cereals such as rye, oats, .

At the same time, the child often exhibits intolerance to other components similar in composition to gluten (avenin).

These substances, entering the child’s intestines, cause him irritation, which negatively affects not only the functionality of this organ, but also the condition of other organs of the digestive system. As a result of this, there are specific symptoms celiac disease.

Characteristic feature This disease is due to the fact that the condition of the child’s digestive system quickly improves and is restored provided there are no gluten-containing products in the diet.

Celiac disease in children can occur asymptomatic(hidden form), with the appearance characteristic features intestinal lesions (typical form), or with the manifestation of symptoms of damage to other organs of the digestive tract (atypical form).

There are also several stages of development diseases:

1. On initial stage There are no symptoms of the disease.
2. The composition of the blood changes, in particular, the level of leukocytes and red blood cells increases.
3. There is slight damage to the cilia of the intestinal epithelial layer.
4. The cilia are damaged to a greater extent, and signs of atrophy are observed.
5. An irreversible process of damage to the intestinal epithelium.

Causes

Currently, the exact cause of the development of celiac disease in children has not been established, however, there is reason to believe that this disease occurs as a result of such unfavorable factors as:

There are also numerous minor factors, the presence of which can provoke the development of the disease. These factors include:

• infectious diseases that cause disruption of the digestive system;
• surgical operations or traumatic injury to the gastrointestinal tract;
• long-term decrease in immunity;
• some diseases, such as rheumatoid;
• congenital or acquired changes in the structure of the intestine.

Symptoms and signs

How does the disease manifest itself? Celiac disease is difficult to recognize at the initial stage of its development, since the symptoms of the disease appear not from the moment of birth.

And when the child reaches 6-7 months of age(sometimes this happens much later), even if we are talking about a congenital form of the disease.

If the child is on breastfeeding, signs of pathology appear when the child’s diet becomes more varied (introduction of complementary foods), and cereal porridges and other gluten-containing products appear in the baby’s daily menu.

To the number characteristic features pathologies include:

1. Insufficient gains in height and weight.
2. Sudden mood swings (the child can behave actively, aggressively, is often capricious, and after some time this state is replaced by a period of lethargy and apathy).
3. Changes in stool. The number of bowel movements increases, and the stool acquires a liquid, foamy consistency and an unpleasant odor.
4. The appearance of paroxysmal abdominal pain.
5. Signs (photo).
6. Anomalies of the dentition (the baby’s teeth are much later than expected, while the enamel of the teeth has increased sensitivity, as a result of which the child often develops caries).
7. Swelling.
8. Intolerance to animal protein, which is contained in cow's milk and products based on it.

Complications and consequences

Disability

However, if the disease is severe and rapidly developing, and the child does not receive necessary treatment, possible disability.

Thus, celiac disease negatively affects the general condition of the child’s body, in particular, the condition of his musculoskeletal system. And such disorders, leading to frequent fractures, can cause disability.

Diagnostics

To make a diagnosis, the doctor needs to evaluate the child's condition after eating foods containing gluten. To do this, the child is examined and interviewed, and additional research methods are prescribed, such as:

Treatment options

Therapy for celiac disease must be comprehensive, in particular, the child must take medications prescribed by the doctor and adhere to rules of a gluten-free diet.

In addition to this, the use of traditional methods treatments that have a positive therapeutic effect during exacerbation of the disease (herbal decoctions that normalize the functioning of the gastrointestinal tract).

The child is prescribed enzyme preparations that improve digestion ( Mezim, Creon). To restore normal intestinal microflora, the use of probiotics is indicated ( Bifidumbacterin, Hilak).

And to compensate for the lack of vitamins and microelements, a course of vitamin complexes designed for children of a particular age is necessary.

Diet therapy

Diet - one of fundamental points successful therapy.

Stick to certain rules A child needs nutrition throughout his life.

Yes, from the diet must be excluded products made from wheat, rye, barley, oats (only buckwheat and rice are recommended for cereals), dairy products and whole milk, as well as products prepared on its basis (for example, ice cream), bread, pastries, semi-finished meat products, sausages products, canned food.

Prevention

Any effective ways prevent the development of celiac disease in a child, does not exist.

However, in order to prevent an attack from occurring, the baby must adhere to the principles of a gluten-free diet throughout his life.

In adolescence and beyond, bad habits and violation of nutrition rules are unacceptable. Moreover, if there is family history(the child’s parents also suffer from this disease), it is necessary to regularly visit specialists with the child for a preventive examination (at least 2 times a year).

This will allow you to identify the problem at an early stage and begin treatment as soon as possible.

Proper nutrition necessary for the successful development of a child. Disorders of the gastrointestinal tract, which include celiac disease, can lead to very serious consequences, such as developmental delays, disability and even death.

Therefore, it is necessary to identify this problem as early as possible and begin appropriate treatment, which consists of taking medications, compliance with the recommended diet and diet.

It is necessary to follow the doctor's instructions throughout the rest of my life, since it is not possible to completely cure this disease.

About the diet for celiac disease in adults and children in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Celiac disease- a disease in which persistent digestive upset occurs caused by a violation of the absorption process in the small intestine of carbohydrates and fats due to intolerance to gluten (gliadin) - the gluten protein of some cereals: wheat, oats, rye, barley.

information Patients are diagnosed with insufficiency of the enzymatic systems of cells in the intestines, which are involved in the breakdown of the gluten peptide. At the same time, the human body produces antibodies against gliadin.

Celiac disease usually develops in children two to three years old. Symptoms of the disease are almost invisible at first, but then the disease progresses, the child begins to lose weight and lag behind his peers in height. In some cases, the first signs of a disorder can be noticed even in infants who are intolerant to cow's milk.

Modern research has established that 0.5-1% of the entire population is prone to developing celiac disease, which is millions of people throughout the planet.

Causes

The exact causes of celiac disease in children have so far been definitively not installed. There are the following versions of the origin of this disease:

• hereditary predisposition- the main suspected cause of the disease. Scientists believe that gluten intolerance occurs due to damage to the human genes that are responsible for susceptibility to this substance;
• autoimmune theory- it is assumed that persistent irritation of the intestinal walls occurs due to the effects of protein breakdown products from cereals. Damaged cells are attacked by the human immune system;
• virus theory: arose due to the fact that antibodies to certain types of adenoviral infection (for example, to “stomach flu”) were found in the blood of patients.

Symptoms of celiac disease in children

Children with celiac disease experience the following: symptoms:

• loss of appetite, insufficient weight gain;
• increased weakness, fatigue;
• pale skin;
• anemia ( low level hemoglobin), muscle hypotonia;
• increased abdominal size - observed due to flatulence and increased fluid content in the intestinal loops;
• growth retardation: in the absence of treatment, the height of girls may not exceed 155 cm, and for boys - 165 cm;
• prolonged diarrhea (diarrhea);
• nausea, vomiting;
• delayed sexual development: absence of menstruation in girls under 15 years of age, insufficient development of the mammary glands;
• dermatitis herpetiformis - the appearance of a rash on the skin in the form of blisters or spots, severe itching of the affected areas;
• osteoporosis - increased fragility of bones: occurs in 50% of children suffering from celiac disease. The disease occurs due to a disruption in the absorption of minerals in the digestive tract in celiac disease.

After eliminating foods containing gluten from a child's diet, bone density is restored to normal levels. within one year.

Diagnostics

The diagnosis of celiac disease can be confirmed using the following methods:

• coprogram - with the help of this study you can determine the level of fatty acids in the feces;
• blood chemistry ;
• intestinal colonoscopy;
• X-ray of bones - performed to determine bone density;
• analysis of biopsy samples of the small intestinal mucosa.

In addition, in order to finally establish the analysis, the doctor may recommend that parents exclude foods that containing gluten, from the child’s diet, for several days. If after two or three days the baby’s condition improves significantly and the unpleasant symptoms from the digestive system disappear, then cereal protein intolerance really exists.

Treatment of celiac disease in a child

The main treatment for celiac disease in children is complete eliminating foods from the diet that contain gluten. Such grain crops are wheat, oats, rye and barley.

additionally Please be aware that some prepared products (e.g. tomato sauce) offered by the food industry may contain small amounts of wheat flour, and even a small amount of gluten-containing foods can be harmful to the baby. Therefore, when purchasing food products, it is necessary to carefully study the composition of the ingredients on the packaging.

Instead of wheat or rye bread, the child’s diet includes bakery products from rice, buckwheat, corn or soy flour. Unfortunately, not all localities can find similar products on sale - in this case you will have to prepare gluten-free food on one's own.

In addition to following a gluten-free diet, the following methods are used in the treatment of celiac disease:

• restriction in the diet of fatty foods;
• prescription of vitamins;
• additional intake of drugs containing enzymes and minerals: pancreatin, methionine, calcium glycerophosphate, enteroseptol - this helps to normalize the digestion process and replenish the deficiency of minerals in the body;
• prescribing probiotics- medications that help restore intestinal microflora.

information Don't assume that a gluten-free diet means eating tasteless foods. The diet can include sufficient quantities of potatoes, rice, corn flour products, honey, fruits, vegetables, milk, low-fat cottage cheese, fish, and meat.

Among fats, preference should be given to foods plant origin.

Complications

If not detected in time illness and lack of treatment in children, such serious disorders as significant growth retardation, a tendency to bone fractures, arthritis, anemia, and decreased immunity occur.

Subject to following a gluten-free diet, the appearance of the above complications can be avoided.

Prevention of celiac disease

Unfortunately, It is not possible to prevent the onset of celiac disease, since this disease develops under the influence of a hereditary factor or under the influence of autoimmune disorders.

Preventive measures can only consist of constant monitoring of the baby's health in order to timely detect suspicious symptoms, which will avoid the occurrence of serious digestive disorders and metabolic disorders.

Consequences

If your child is diagnosed with celiac disease, they will need to follow a gluten-free diet. throughout life. Even 10-20 years ago this was quite difficult, but nowadays the food industry offers a large range of gluten-free food products. If such goods are not available in trading establishments of one or another settlement, you can order them online or prepare the food yourself. The main thing in the treatment of celiac disease is to prevent your child from eating prohibited foods, even occasionally, so as not to provoke an exacerbation of the disease.

Celiac disease in children – hereditary disease, affecting the intestinal mucosa due to intolerance to gluten, which is found in large quantities in cereals. Often this disease develops in children starting from the age of two; the signs are mild, but as the disease progresses they become more pronounced. In some cases, the first symptoms can be noticed in an infant who has an intolerance to cow's milk. After eliminating foods containing gluten protein from the diet, the condition improves and returns to normal within a year.

The exact reasons for the progression of this disease in children have not been established, but it is believed that predisposing factors are genetic predisposition, autoimmune diseases that carry Negative influence on the intestinal mucosa, some types of viral infections. The main manifestations of this syndrome are considered to be lack of appetite and loss of body weight, liquid and foamy stool, increased abdominal volume, delayed growth and sexual development.

Diagnosis of the disease is based on laboratory studies of stool and blood, intestinal biopsy and instrumental examinations of the child. Treatment of this syndrome is based on following a special diet, taking vitamin complex and enzymes to improve the functioning of the digestive system. Without timely treatment, the disease can cause disability or death of the child.

Etiology

The main cause of gluten intolerance syndrome is genetic disorders that create favorable conditions to damage the structure of the intestinal mucosa when consuming certain grains. There are several favorable factors contributing to the development of the disease:

• the presence of a similar disorder in close relatives;
• autoimmune diseases of the thyroid or pancreas, against which the immune system attacks its own cells;
• an inflammatory process in the intestine, due to which lymphocytes accumulate in the cells of this organ;
• wide range;
• prolonged influence of stressful situations on the child;
• complications after surgical intervention, for example, after deleting .

However, the exact reasons for the formation of the disease in children are not fully known.

Varieties

In modern medicine, there are several forms of celiac disease in children:

• typical – there are disturbances in the functioning of the gastrointestinal tract and intolerance to any dairy products;
• atypical – symptoms of the disease may not appear at all;
• hidden - in most cases it occurs without expressing any signs;
• latent – ​​manifestations of the disease are completely absent. Diagnosis is carried out by studying blood and stool tests;
• refractory – accompanied by pronounced symptoms. It differs from other forms in that if the diet is followed, there is no improvement in the child’s condition. This causes disability or death.

Symptoms

The primary manifestation of the syndrome is not immediately apparent. In infants, signs begin to appear when complementary foods are introduced, when gluten-containing foods are added to the diet. The symptoms of the disease make themselves felt more clearly in babies under one year old - starting from eight months. Some children character traits appear around the age of three.

Signs of this disorder in children under two years of age:

• liquid feces containing particles of fat and foam. They often have a persistent unpleasant odor;
• increase in abdominal volume;
• attacks of nausea ending in vomiting;
• lag in growth and weight gain compared to healthy peers;
• constant tearfulness and agitation of the child;
• delay in psychomotor development - children later than others begin to hold their heads independently, show interest in new toys and people, crawl and walk.

Symptoms of the disease in children over two years of age and adolescents:

• diarrhea, alternating;
• pale skin;
• increased fatigue;
• delayed puberty. Girls may start menstruating by age fifteen or later. There is insufficient development of the mammary glands;
• stunted growth - in girls it does not exceed 155 cm, in young people - 165 cm;
• allergic reactions - the appearance of a characteristic rash on the skin;
• – there is a decrease in bone density. Occurs in half of children diagnosed with celiac disease. After eliminating grains, bone density is restored. The entire process takes no more than one year. In some cases, it may become a factor in the occurrence of disability;
• increased hair loss.

Complications

With late diagnosis and treatment of the disease, as well as non-compliance with the diet, there is a possibility of developing the following complications:

• persistence of symptoms of this disorder even when all rules regarding nutrition are followed;
• formation of ulcers of the small intestine;
• infertility – observed in severe cases of the disease;
• deficiency of vitamins in the body;
• significant mental and mental retardation;
• increasing the likelihood of oncology of the gastrointestinal tract;
• frequent bone fractures or disability – due to decreased bone density;
• lethal outcome - with the rapid development and severe course of celiac disease in children under two years of age.

By following a gluten-free diet throughout your life, many of the above consequences can be avoided.

Diagnostics

The specialist establishes the primary diagnosis based on examination of the patient, determining possible reasons the formation of diseases, the presence and intensity of certain symptoms. The examination includes measurement of height and body weight, palpation of the abdomen. Laboratory tests are of primary value in diagnosing celiac disease in children:

• blood – general and biochemical;
• microscopic and bacteriological examination of feces;
• genetic tests.

Instrumental methods to confirm the diagnosis include an intestinal biopsy, during which a small piece of the mucous membrane is taken for subsequent detailed examination. FGDS - allows a specialist to examine and evaluate the structural condition of the gastrointestinal tract. Ultrasound of the abdominal organs - to search for and confirm the presence of intestinal damage and digestive disorders. Densitometry - allows you to determine the density of bone tissue.

In addition, consultation with an allergist-immunologist is necessary. During diagnosis, some specialists ask not to give the child foods containing gluten for several days, after which they repeat some tests and assess the patient’s general condition. When the indicators change in better side accurately establish the diagnosis "".

Treatment

Treatment of celiac disease in children necessarily involves a lifelong avoidance of grains containing gluten, such as wheat, barley and rye. Completely excluded semolina, pasta and bakery products based on flour from the above cereals. In addition, it is worth limiting the consumption of sausages, smoked meats, ice cream, chocolate, various sauces, ketchups and mayonnaise, coffee and cocoa, and canned food. This is due to the fact that they may also contain this protein. It is allowed to take products made from rice and corn flour, as well as potatoes, fish, meat and fruits. Subject to proper nutrition, the first improvements are visible within a month - complete restoration of the intestinal mucosa occurs throughout the year.

In addition, treatment of this syndrome is aimed at eliminating symptoms not related to the gastrointestinal tract. Often patients are prescribed:

• drugs to increase hemoglobin levels;
• medications containing calcium and vitamin D - necessary to strengthen bone tissue. Normalization of bone density is achieved in about a year. Otherwise, increased bone fragility can lead to disability;
• vitamin complexes.

If necessary, courses of therapy are prescribed by a psychotherapist. With timely and proper treatment the prognosis of the disease is favorable.

Prevention

There is no specific prevention of celiac disease in children; it is only necessary to follow a diet throughout life, and in the future to refuse bad habits– drinking alcohol and smoking tobacco. To confirm the hereditary factor and the presence of predisposing factors, you need to undergo regular examinations by specialists - at least twice a year. If the first signs of the syndrome occur, immediately contact a medical facility. The sooner treatment begins, the higher the likelihood of a full recovery and the absence of undesirable consequences, including disability and death.

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